| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
|
30,155 |
26,795 |
$492K |
| A0429 |
Bls-emergency |
5,168 |
3,916 |
$410K |
| G0480 |
Drug test def 1-7 classes |
7,972 |
6,338 |
$352K |
| 96374 |
|
4,882 |
4,345 |
$227K |
| 74177 |
|
1,040 |
957 |
$209K |
| 90853 |
|
31,211 |
3,671 |
$177K |
| 70450 |
|
2,635 |
2,491 |
$139K |
| 76805 |
|
1,744 |
1,711 |
$118K |
| Z7502 |
|
3,110 |
3,034 |
$116K |
| 85025 |
|
18,235 |
16,104 |
$115K |
| 80053 |
|
13,795 |
12,351 |
$103K |
| 76801 |
|
1,982 |
1,772 |
$98K |
| 87426 |
|
3,957 |
3,600 |
$98K |
| 96372 |
|
5,138 |
4,439 |
$94K |
| 93005 |
|
5,399 |
4,895 |
$82K |
| 76815 |
|
2,046 |
1,345 |
$81K |
| 96375 |
|
2,809 |
2,460 |
$74K |
| 59025 |
|
4,510 |
1,368 |
$74K |
| 99199 |
|
1,246 |
1,175 |
$71K |
| 76817 |
|
1,313 |
1,141 |
$68K |
| 76856 |
|
1,194 |
1,138 |
$59K |
| 96361 |
|
3,098 |
2,668 |
$52K |
| 76816 |
|
1,414 |
1,330 |
$49K |
| 74176 |
|
510 |
463 |
$48K |
| 96360 |
|
1,197 |
1,057 |
$47K |
| Z9725 |
|
1,285 |
1,279 |
$45K |
| 76830 |
|
792 |
755 |
$44K |
| 76813 |
|
944 |
868 |
$39K |
| J3490 |
Drugs unclassified injection |
8,738 |
6,538 |
$37K |
| 71045 |
|
4,197 |
3,906 |
$36K |
| 84484 |
|
4,594 |
3,999 |
$33K |
| 87635 |
|
973 |
820 |
$32K |
| J7030 |
Normal saline solution infus |
4,432 |
3,620 |
$29K |
| 83880 |
|
1,300 |
1,189 |
$26K |
| J1885 |
Ketorolac tromethamine inj |
4,804 |
4,137 |
$26K |
| 83690 |
|
4,755 |
4,307 |
$24K |
| 80048 |
|
4,171 |
3,794 |
$22K |
| 87804 |
|
2,618 |
2,075 |
$22K |
| 87631 |
|
520 |
476 |
$21K |
| 87086 |
|
3,832 |
3,529 |
$21K |
| 96365 |
|
501 |
469 |
$21K |
| 76705 |
|
485 |
455 |
$19K |
| 81025 |
|
6,339 |
5,863 |
$17K |
| J2405 |
Ondansetron hcl injection |
3,454 |
3,035 |
$16K |
| 87650 |
|
1,345 |
1,307 |
$16K |
| 81001 |
|
7,650 |
7,018 |
$16K |
| 71046 |
|
931 |
878 |
$15K |
| 99283 |
|
1,493 |
1,379 |
$14K |
| 88305 |
|
810 |
753 |
$14K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,330 |
1,219 |
$13K |
| 72125 |
|
184 |
170 |
$12K |
| 43239 |
|
220 |
201 |
$11K |
| 0270 |
|
14,283 |
8,774 |
$10K |
| 83605 |
|
1,306 |
1,161 |
$9K |
| J7120 |
Ringers lactate infusion |
1,336 |
1,171 |
$9K |
| 85730 |
|
2,355 |
2,119 |
$8K |
| 93458 |
|
13 |
12 |
$8K |
| J2704 |
Inj, propofol, 10 mg |
1,188 |
1,089 |
$8K |
| 85610 |
|
2,846 |
2,547 |
$7K |
| 82948 |
|
2,620 |
2,140 |
$7K |
| 94640 |
|
545 |
482 |
$7K |
| J0696 |
Ceftriaxone sodium injection |
1,042 |
905 |
$6K |
| 87070 |
|
1,302 |
1,248 |
$6K |
| 99284 |
|
467 |
432 |
$6K |
| 87186 |
|
868 |
797 |
$6K |
| J3010 |
Fentanyl citrate injection |
1,076 |
961 |
$5K |
| 84702 |
|
926 |
821 |
$5K |
| 80307 |
|
105 |
95 |
$5K |
| 45378 |
|
67 |
56 |
$5K |
| 0360 |
|
1,347 |
964 |
$5K |
| J2765 |
Metoclopramide hcl injection |
892 |
776 |
$5K |
| J2270 |
Morphine sulfate injection |
770 |
688 |
$5K |
| 80305 |
|
481 |
457 |
$4K |
| J2250 |
Inj midazolam hydrochloride |
922 |
813 |
$4K |
| 90715 |
|
139 |
127 |
$4K |
| 99285 |
|
57 |
54 |
$4K |
| 82150 |
|
871 |
826 |
$3K |
| 0710 |
|
1,608 |
1,447 |
$3K |
| 88342 |
|
245 |
223 |
$3K |
| 83735 |
|
571 |
494 |
$3K |
| 87880 |
|
448 |
410 |
$3K |
| 84703 |
|
1,212 |
1,141 |
$2K |
| Z7610 |
|
257 |
199 |
$2K |
| 86901 |
|
1,126 |
997 |
$2K |
| 86900 |
|
1,124 |
996 |
$2K |
| 88313 |
|
230 |
212 |
$2K |
| 0250 |
|
1,683 |
1,149 |
$2K |
| 87040 |
|
239 |
217 |
$2K |
| J1100 |
Dexamethasone sodium phos |
265 |
232 |
$1K |
| J0561 |
Penicillin g benzathine inj |
12 |
12 |
$1K |
| 45380 |
|
62 |
53 |
$1K |
| J0690 |
Cefazolin sodium injection |
210 |
172 |
$1K |
| J1200 |
Diphenhydramine hcl injectio |
272 |
213 |
$1K |
| J1170 |
Hydromorphone injection |
141 |
131 |
$1K |
| 73564 |
|
45 |
42 |
$862.40 |
| 0300 |
|
1,325 |
279 |
$824.73 |
| 73130 |
|
45 |
39 |
$797.02 |
| 87077 |
|
107 |
94 |
$776.43 |
| 82553 |
|
145 |
140 |
$720.37 |
| 73610 |
|
50 |
48 |
$697.02 |
| 73630 |
|
44 |
42 |
$658.00 |
| J7050 |
Normal saline solution infus |
64 |
60 |
$631.33 |
| 85027 |
|
122 |
104 |
$616.15 |
| J2060 |
Lorazepam injection |
120 |
79 |
$589.17 |
| 82550 |
|
141 |
139 |
$587.84 |
| 86850 |
|
251 |
210 |
$484.36 |
| 90471 |
|
135 |
123 |
$476.82 |
| 88312 |
|
47 |
41 |
$422.12 |
| 76857 |
|
14 |
13 |
$383.89 |
| 99281 |
|
81 |
54 |
$347.20 |
| J1644 |
Inj heparin sodium per 1000u |
71 |
52 |
$317.93 |
| 74021 |
|
14 |
14 |
$311.25 |
| J7040 |
Normal saline solution infus |
47 |
32 |
$294.67 |
| 82009 |
|
78 |
61 |
$272.75 |
| J3486 |
Ziprasidone mesylate |
60 |
38 |
$269.00 |
| 0762 |
|
452 |
404 |
$233.88 |
| S0164 |
Injection pantroprazole |
28 |
14 |
$218.37 |
| S0020 |
Injection, bupivicaine hydro |
19 |
17 |
$216.57 |
| A4217 |
Sterile water/saline, 500 ml |
28 |
28 |
$207.48 |
| 0370 |
|
317 |
287 |
$203.80 |
| 87081 |
|
30 |
26 |
$179.32 |
| 36415 |
|
2,087 |
1,853 |
$177.96 |
| J2930 |
Methylprednisolone injection |
13 |
12 |
$173.54 |
| 84550 |
|
48 |
40 |
$137.67 |
| J0131 |
Inj, acetaminophen (nos) |
14 |
12 |
$123.52 |
| 84460 |
|
32 |
26 |
$116.91 |
| 87420 |
|
60 |
55 |
$114.26 |
| 84450 |
|
32 |
26 |
$112.65 |
| 82565 |
|
32 |
26 |
$110.07 |
| 84520 |
|
32 |
26 |
$80.43 |
| 0100U |
|
130 |
102 |
$76.30 |
| J2550 |
Promethazine hcl injection |
12 |
12 |
$75.75 |
| 87088 |
|
12 |
12 |
$46.89 |
| 81003 |
|
25 |
25 |
$44.42 |
| 87147 |
|
12 |
12 |
$36.54 |
| 99001 |
|
335 |
310 |
$8.85 |
| Q0162 |
Ondansetron oral |
30 |
29 |
$3.04 |
| 80320 |
|
101 |
98 |
$0.00 |
| 0324 |
|
53 |
50 |
$0.00 |
| 0310 |
|
24 |
19 |
$0.00 |
| 0254 |
|
32 |
27 |
$0.00 |
| 0636 |
|
175 |
95 |
$0.00 |
| 76818 |
|
117 |
95 |
$0.00 |
| 0260 |
|
95 |
79 |
$0.00 |
| 0760 |
|
236 |
197 |
$0.00 |
| 0160 |
|
60 |
49 |
$0.00 |
| 0402 |
|
143 |
96 |
$0.00 |
| 0320 |
|
39 |
30 |
$0.00 |
| 0272 |
|
106 |
62 |
$0.00 |
| 0481 |
|
20 |
12 |
$0.00 |